Nurses, UMass Memorial at odds over staffing

The layoff notices have been rolling in at UMass Memorial Health Care, as the region's largest health care provider works to trim $80 million off its books.

Last week, seven nurses in the maternity ward at the Memorial Campus were laid off. Last month, six other maternity nurses were “bumped” from their positions by more senior nurses coming over to the department from the Home Health and Hospice business, which UMHC sold to VNA Care Network and Hospice. These cuts come on top of layoffs involving 19 maternity nurses' aids in March, which has forced nurses to do more nonmedical jobs, like making beds. Last year, UMHC laid off all five of the department's lactation nurses and replaced them with lactation consultants, who are not nurses, from an outside agency. Positions vacated by retirements, turnover and injury leave are not being filled.

And that is just in the Memorial Campus maternity ward.

The layoffs, announced in September and pegging about 140 positions throughout the UMass Memorial system, come as the 2,000 UMass Memorial nurses represented by the Massachusetts Nurses Association seek to negotiate a new contract. UMass Memorial nurses have been working without a contract since the first of the year. On Thursday, the union notified UMHC's management that they will stage an informational picket outside the hospital's campuses on Thursday, Nov. 8.

For the nurses, the main sticking point in negotiations is staffing.

In the maternity ward, the union is asking that UMHC meet staffing levels recommended by the Association of Women's Health, Obstetric & Neonatal Nurses, which recommends one nurse for every three normal, healthy baby-mother couples. Nurses should not be caring for more than two women recovering from a cesarean birth. For babies who have complications, the recommended ratio is one nurse to every three to four babies requiring continuing care. For the sickest and weakest newborns, the recommendation is one nurse to each baby.

Lynne Starbard, a day-shift maternity nurse at the Memorial Campus, is co-chairwoman of the union team that represents the Memorial and Hahnemann campuses. She said UMass Memorial is refusing to meet those recommended staffing levels for its maternity department, although St. Vincent Hospital recently agreed to meet the same standards.

She said the nurses are not seeking raises. They want to keep their current retirement and health benefits, and have UMass Memorial agree to meet certain staffing levels.

In response to questions about the layoffs, UMHC spokesman Robert Brogna said in a written statement that “patient safety and quality care are at the forefront of every decision we make.

“We recently undertook a careful review of service lines where fewer people are using our services than in the past, often due to demographic shifts, and where we don't expect to see an improvement in volume, and staff reductions were made accordingly. It's a fact that if we don't adjust our costs to align with that reality, we will not have a sustainable financial underpinning,” Mr. Brogna wrote.

“Positions impacted are in corporate as well as clinical areas and involve all levels of staffing, including management positions and nurses. We are consolidating some units, closing beds, and consolidating management structures in our inpatient setting.

“It is always the case that patient volume can shift from time to time, and we have procedures in place to respond quickly when necessary and increase staffing to meet demand if there are spikes in volume. We are, of course, concerned anytime staffing issues are raised in a patient setting, and we will look into the issues raised by these nurses to make sure all available resources are being used when needed,” Mr. Brogna concluded.

Ms. Starbard said she has filed an unsafe staffing complaint with UMass Memorial management every day for the past two years.

“I'm in the office daily with management, saying what the problems are,” she said. “No one seems to be listening.”

Another result of the cuts is rampant overtime, resulting in 50- to 60-hour weeks being the norm for many nurses, and not just in maternity.

Although mandatory overtime has been made illegal, nurses in the Memorial Campus maternity ward say they feel an “ethical” obligation to stay on past the end of their shifts.

“Your shift ends, but you can't really leave, because there's not enough nurses to handle the patients,” said Michele Moynihan of Rutland, a per diem nurse in Memorial's maternity ward. The cuts have left morale in the department at an all-time low, said several nurses.

“I've been working in the hospital for 10 years, and this is the worst I have seen it in my time there,” said Nathalie Gibson, a night-shift maternity nurse from Worcester who works at the Memorial Campus. “They are constantly building new buildings, opening new units, yet they keep trying to close floors at our hospital.”

Contact Aaron Nicodemus by email at anicodemus@telegram.com or at (508) 793-9245.

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